Bonuses stop for state disability doctors

Some had received hundreds of thousands to work through backlog

Previously

California has stopped issuing hundreds of thousands of dollars per year in bonuses to doctors who conduct rapid-fire reviews of U.S. Social Security Administration disability cases.

Two doctors were the top-paid employees of state departments in San Diego County in 2010, thanks to bonuses that totaled as much as $306,000 for one of them.

Two months after U-T Watchdog revealed the program in 2011, it was suspended. Officials from the California Department of Social Services said they got additional help from other states to process requests for disability applications, so they no longer needed to pay the bonuses to the unionized doctors to ease a backlog.

The Watchdog discovered the cutoff of the program in reviewing 2012 salary data, which recently became available.

Psychiatrist Robert B. Paxton earned $440,068 in 2010, including $306,315 of bonus under the program. His pay fell to $417,000 in 2011, when the bonus was available most of the year, and $151,000 in 2012, the first full year without the bonuses since 1999.

Paxton could not be reached for comment for this story. He previously told the Watchdog the department did not permit him to speak with the media. He earned $1.1 million through the bonus program between 1996 and 2011, according to data from the State Controller’s Office. In all, the program paid out $9.9 million before it was suspended.

The bonus program was an effort to motivate doctors to work through a persistent backlog. It paid the doctors $27 for each case they reviewed in excess of 90 cases per week. Under Social Security policy, the doctors are expected to read through the case files, which can contain hundreds of pages, and determine whether an applicant’s physical or mental health conditions prevent them from working.

As Paxton is salaried, the state has no record of his hours. Assuming 10-hour workdays with no breaks, the Watchdog estimated Paxton spent an average of just under 9 minutes reviewing each of the more than 15,000 cases he reviewed in 2010. The department reviewed the Watchdog’s estimate and said it was reasonable.

According to a review of additional data later obtained from Social Services by the Watchdog, each medical consultant reviewed about 14 cases per day during 2010 and 2011, or one case every 35 minutes on average in an 8-hour workday.

Paxton and other top-paid doctors reviewed more than 100 cases on some days, including 118 reviewed by Paxton on June 14, 2010, or an average of one case every 5 minutes in a 10-hour, no-break workday, according to the data.

San Diego attorney Alise M. Kellman, who has represented disability claimants for 27 years, said the disparity between how quickly a few doctors are able to review the cases in comparison to the rest should have given the department pause.

“There’s no way they could review hundreds of pages, even if they were doing 50 a day,” Kellman said. “People deserve a fair review of their claim. They don’t expect a doctor to spend five minutes and get a denial because they didn’t have a fair review.”